Simple closure or vagotomy and pyloroplasty for the treatment of a perforated duodenal ulcer: Comparison of results

Background/Aims: Treatment of the perforated duodenal ulcer continues to be a controversial subject. The purpose of our study was to compare the resul ts of simple closure of perforated duodenal ulcer versus treatment by trunc al vagotomy and pyloroplasty. Methods: We present a prospective and randomi zed study of 207 patients who underwent surgical treatment due to perforate d duodenal ulcer. In 117 patients the surgical treatment was simple closure and postsurgery medical treatment with proton pump inhibitors for 1 month, and in 90 patients vagotomy and pyloroplasty with no additional medical tr eatment. Results: We applied the Visick scale in order to compare postsurge ry results. The postoperative morbidity and mortality rates were the same w ith both techniques. Statistically, in both cases, no significant differenc es were found in postsurgery symptomatology, The different rates of recurre nt ulcers and the reinterventions due to recurrent ulcers presented no sign ificant statistical values. Conclusion: We conclude that simple closure rem ains the selected treatment in the majority of patients who present with a perforated duodenal ulcer. The operation is a simple and safe procedure, Co pyright (C) 2000 S. Karger AG, Basel.